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Iqbal S, Iqbal H, Kagan C. Intergenerational differences in healthy eating beliefs among British Pakistanis with type 2 diabetes. Diabet Med 2024; 41:e15222. [PMID: 37690127 DOI: 10.1111/dme.15222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 09/12/2023]
Abstract
INTRODUCTION There are growing concerns on how to prevent, slow down and induce remission of type 2 diabetes mellitus (T2DM). Recent evidence has found diet and lifestyle interventions can cause remission of T2DM, however, there are challenges for diverse groups such as British Pakistanis who are four times more at risk of T2DM. There is a need to understand the food behaviours of different generational groups to develop culturally appropriate strategies to support diabetes prevention programmes. AIMS This study explores beliefs about healthy eating and food practices related to T2DM among British Pakistanis to understand the challenges they face in implementing healthy diets. METHOD We carried out 26 semi-structured qualitative interviews via telephone and face-to-face. The sample included T2DM British Pakistanis living in Bradford (UK), aged between 18 and 71 with a mean age of 50 (SD = 17.04). Among the participants, 14 were women (54%) and 12 were men (46%), with interviews conducted in both English (76%) and Urdu (24%). Participants were grouped under three generation groups based on age (first generation 65+; second generation 40-64; younger generation 18-39 years). There was no biological link between the generational groups, and they were not part of the same family. Data were analysed using qualitative reflexive thematic analysis. RESULTS Findings were categorised into three themes: knowledge and awareness of diabetes symptoms; social and family context of food practices and making sense of healthy eating. The family was the fundamental unit of understanding food-related health behaviours. Eating traditional food was perceived as healthy and deemed practical for first generations who were the initial members of their family to settle in the UK as well as the second generations who had parents born in Pakistan. Younger British Pakistanis were born in the UK and reported that they struggled to eat alternative foods within the home and manage their T2DM. CONCLUSION These findings improve our understanding of how three generations of British Pakistanis with T2DM negotiate healthy diets. There is a need for culturally tailored diet modifications and interventions, where different generational needs can be specifically targeted to adopt healthier diets which should be shared and encouraged.
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Affiliation(s)
- Syka Iqbal
- Department of Psychology, Faculty of Management, Law and Social Sciences, University of Bradford, Bradford, UK
| | - Halima Iqbal
- Department of Public Health, Faculty of Health, University of Bradford, Bradford, UK
| | - Carolyn Kagan
- Research institute of Health and Social Change, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
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Rahimi T, Morowatisharifabad MA, Farajkhoda T, Fallahzadeh H. A comprehensive health-promoting neighborhood intervention to improve health care seeking behavior among reproductive age Iranian women. BMC Womens Health 2023; 23:171. [PMID: 37041521 PMCID: PMC10091519 DOI: 10.1186/s12905-023-02308-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 03/26/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Women's health care seeking delays remains an unresolved major public health problem in developing and underdeveloped countries. This study aimed to evaluate a health-promoting neighborhood intervention to improve health care seeking behavior (HCSB) among reproductive age Iranian women using Health Promotion Model (HPM). METHOD This randomized controlled trial was conducted on 160 women of reproductive age in two groups: experimental and control. Data were collected by self-administered questionnaire based on HPM constructs and a medical symptom checklist. A health-promoting neighborhood intervention was performed in seven sessions for the experimental group. HCSB and HPM constructs were measured before and 3 months after intervention in the two groups. p < 0.05 was considered significant level. RESULTS The average mean age of participants was 30.45 ± 7.80 years. After intervention, the mean score of self-efficacy, interpersonal influences, commitment to plan and HCSB was increased significantly in women in the experimental group, while negative constructs such as perceived barriers, negative activity-related affect, and immediate competing demands and preferences significantly decreased (p < 0.05). In addition, the mean score of referring for symptoms such as excessive sweating, persistent fatigue or weakness, headache, bleeding or spotting between periods, vaginal itching and irritation, unusual vaginal discharge, flashing, chest pain, rapid heartbeats, aching muscles or joints, urinary problems and some mental disorder was increased significantly in experimental group compared to control group (p < 0.05). CONCLUSIONS The results of study show that an intervention based on the HPM have a positive impact on HCSB and its associated factors and can help improve women's health behaviors and health outcomes.
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Affiliation(s)
- Tahereh Rahimi
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Tahmineh Farajkhoda
- Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Fallahzadeh
- Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Akuffo-Addo E, Udounwa T, Chan J, Cauchi L. Exploring Biologic Treatment Hesitancy Among Black and Indigenous Populations in Canada: a Review. J Racial Ethn Health Disparities 2023; 10:942-951. [PMID: 35476223 PMCID: PMC9045033 DOI: 10.1007/s40615-022-01282-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 11/30/2022]
Abstract
Biologics are becoming an increasingly important part of patient care across Canada. Recent studies from the USA show that Black patients are less likely than White patients to receive biologic treatment for several medical conditions. The relative lack of race-based data in Canada makes it difficult to replicate such studies in Canada. As a result, there is a paucity of literature that explores the association between biologic usage and race in Canada. Our review aims to explore the factors that might be driving racial treatment disparity in Canada that likely parallels the inequalities found in the USA. We provide a summary of the available literature on the factors that contribute to biologic treatment hesitancy among Black and Indigenous populations in Canada. We highlight several solutions that have been proposed in the literature to address biologic treatment hesitancy. Our review found that biologic treatment decision at the individual level can be very complex as patient's decisions are influenced by social inputs from family and trusted community members, biologic-related factors (negative injection experience, fear of needles, formulation, and unfamiliarity), cultural tenets (beliefs, values, perception of illness), and historical and systemic factors (past research injustices, socioeconomic status, patient-physician relationship, clinical trial representation). Some proposed solutions to address biologic treatment hesitancy among Black and Indigenous populations include increasing the number of Black and Indigenous researchers involved in and leading clinical trials, formally training physicians and healthcare workers to deliver culturally competent care, and eliminating financial barriers to accessing medications. Further research is needed to characterize and address race-based new treatment inequalities and hesitancy in Canada.
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Affiliation(s)
- Edgar Akuffo-Addo
- Undergraduate Medical Education, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada. .,Medical Information, Amgen Canada Inc., Mississauga, ON, Canada.
| | - Theodora Udounwa
- Medical Information, Amgen Canada Inc., Mississauga, ON, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Jocelyn Chan
- Medical Information, Amgen Canada Inc., Mississauga, ON, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Laura Cauchi
- Medical Information, Amgen Canada Inc., Mississauga, ON, Canada
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Arigo D, Lassiter JM, Baga K, Jackson DA, Lobo AF, Guetterman TC. "You get what you need when you need it": A mixed methods examination of the feasibility and acceptability of a tailored digital tool to promote physical activity among women in midlife. Digit Health 2023; 9:20552076231210654. [PMID: 37954685 PMCID: PMC10638881 DOI: 10.1177/20552076231210654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/12/2023] [Indexed: 11/14/2023] Open
Abstract
During midlife (ages 40-60), women experience myriad changes that elevate their risk for cardiovascular disease (CVD), including decreased physical activity (PA). Women cite lack of social support for PA and lack of active peers who can serve as role models as key barriers. Digital tools such as web applications can provide exposure to these social inputs; they are also accessible in daily life and require modest time investment. However, as few tools have been designed to meet the unique needs of women in midlife with CVD risk, our research team previously built a web application that is tailored for this population. In the present study, we used a convergent mixed methods design to develop a deep understanding of the feasibility, usability, and acceptability of this web application in a sample of identified end users. Participants (N = 27, MAge = 53 years, MBMI = 32.6 kg/m2) used the web application at the start of each day for 7 days and completed a 1-hour qualitative interview at the end of this test period. Integration of findings from two-level multilevel models (quantitative) and thematic analysis (qualitative) indicated support for the feasibility, usability, and acceptability of the new web application among women in midlife with CVD risk conditions and identified critical opportunities for improving the user experience. Findings also speak to the utility of options for content selection that can meet women's needs in daily life and highlight women's desire for PA resources that prioritize their perspectives.
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Affiliation(s)
- Danielle Arigo
- Department of Psychology, Rowan University, Glassboro, NJ, USA
- Department of Family Medicine, Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
| | | | - Kiri Baga
- Department of Psychology, Rowan University, Glassboro, NJ, USA
| | - Daija A Jackson
- Department of Clinical Psychology, Chicago School of Professional Psychology, Washington, DC, USA
| | - Andrea F Lobo
- Department of Computer Science, Rowan University, Glassboro, NJ, USA
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Self-Care Behaviors in Patients with Hypertension to Prevent Hypertensive Emergencies: a Qualitative Study Based on the Theory of Planned Behavior. JOURNAL OF CARDIOVASCULAR EMERGENCIES 2022. [DOI: 10.2478/jce-2022-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
Abstract
Background: Hypertension is a crucial general health issue. Severe and acute hypertension needs urgent medical intervention. Self-care behaviors can help patients with hypertension in controlling blood pressure and preventing hypertensive emergencies. This study aimed to determine the perception of hypertension towards self-care behaviors using constructs of the theory of planned behavior (TPB) in critically ill patients with hypertension to prevent hypertensive emergencies.
Material and Methods: This study was conducted based on the directed qualitative content analysis of 33 critically ill patients with hypertension who participated in semi-structured interviews and focus group discussions. Results: The data were analyzed based on the four main categories of TPB. The attitude category consisted of positive and negative subcategories. The subjective norms category consisted of authority of healthcare staff, family support and approval, and influence of friends subcategories. The perceived behavioral control category included discipline, self-control, receiving consultation, individual concerns, financial problems, access to medicine, food culture, and coronavirus limitations subcategories. The behavioral intention category had intention to perform the behavior and intention to continue a behavior subcategories.
Conclusion: The results revealed the requirement for a multidimensional approach to improve attitude, subjective norms, and behavioral control for performing self-care behaviors to reduce the number of hypertensive emergencies in critically ill patients with hypertension. Factors affecting self-care included socioeconomic status, family support, governmental organizations, and participants’ health condition.
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Assessing predictors of self-management intentions in people with type 2 diabetes. BMC Health Serv Res 2022; 22:370. [PMID: 35313871 PMCID: PMC8935112 DOI: 10.1186/s12913-022-07731-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 02/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background Type 2 diabetes mellitus (T2D) is slowly turning into an international health emergency, evidenced by accelerated growth in prevalence rates worldwide. Experts have now called for greater integration of self-management interventions in clinical practice in light of these worrisome trends, supplanting the prevailing notion of a “glucocentric” approach. In this pilot study designed to complement a novel assessment program currently in development, we describe a concise screening tool designed to stratify the intention to follow through on self-management practices in people with T2D. Methods A cross-sectional survey was conducted at 3 regional primary care clinics. Individuals with T2D having the following characteristics were recruited into the study: (i) individuals with T2D between 18 and 65 years, (ii) fluent in English and, and iii) having been diagnosed with T2D for at least 2 years. We assessed the relevance of components in the Theory of Planned Behaviour (TPB) within the context of self-management behaviour in T2D. Participants were requested to complete a questionnaire containing questions related to intention, attitudes subjective norm and perceived behavioural control. Based on their responses, the psychometric properties of the scale were then evaluated using both reliability and validity analysis. Results The Cronbach α value for all direct measures of TPB was excellent: intention to adhere to self-management practices (0.98), attitude towards self-management behaviour (0.87), subjective norm (0.83), and perceived behaviour control (0.66). The correlation between intentions and all 3 constructs of TPB was excellent (p < 0.01). Structural equation modeling helped determine attitudes and subjective norms as important predictors of intentions to follow through self-management practices. Conclusions By first understanding the dimensions that influence intentions associated with self-management behaviour, clinicians have the opportunity to “triage” individuals with T2D who require greater involvement to bring about better self-care practices. Thus, our research attempts to bridge this gap by devising a psychometric tool suited to a regional setting which allows for an improved person-centered communication between clinicians and patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07731-x.
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Khin ET, Aung MN, Ueno S, Ahmad I, Latt TS, Moolphate S, Yuasa M. Social Support between Diabetes Patients and Non-Diabetes Persons in Yangon, Myanmar: A Study Applying ENRICHD Social Support Instrument. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147302. [PMID: 34299754 PMCID: PMC8303506 DOI: 10.3390/ijerph18147302] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 12/28/2022]
Abstract
Diabetes patients, due to the chorionic nature of the disease, need complex and long-term care for control and prevention of complications. The patients themselves find it difficult to adopt appropriate disease management after diagnosis and they need social support from family, friends, and their environment, especially in lower- and middle-income countries where medical service is limited, and they need self-care of disease and lifestyle modification. In Myanmar, however, the study for social support among diabetes patients is still limited. Therefore, we conducted a case-control study to investigate the social support among diabetes patients and the association between socioeconomic factors in Yangon, which has the highest prevalence of diabetes in Myanmar. Social support between diabetes patients who came to diabetes special clinics and non-diabetes community control was assessed by applying transculturally translated ENRICHD Social Support Instrument (ESSI). Among the diabetes patients’ group, more than 70% had high perceived social support, specifically higher level of informational and emotional social support. Robust multiple regression models revealed significant positive associations between total social support and independent variables: p value < 0.001 for monthly household income and being married, and p value < 0.05 for household number and frequency of having meals together with family. These findings suggest that perceived social support among patients with diabetes may be mainly affected by the patients’ family conditions, such as household income and living with a spouse, in Myanmar culture.
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Affiliation(s)
- Ei Thinzar Khin
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
| | - Myo Nyein Aung
- Advanced Research Institute for Health Sciences, Juntendo University, Tokyo 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
- Correspondence: ; Tel.: +81-33813-3111
| | - Satomi Ueno
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
- Faculty of Nursing, Seisen Jogakuin College, Nagano 381-0085, Japan
| | - Ishtiaq Ahmad
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
| | - Tint Swe Latt
- Myanmar Diabetes Association (MMDA), Yangon 11211, Myanmar;
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiangmai 50300, Thailand;
| | - Motoyuki Yuasa
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
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Ogunlana MO, Govender P, Oyewole OO, Odole AC, Falola JL, Adesina OF, Akindipe JA. Qualitative exploration into reasons for delay in seeking medical help with diabetic foot problems. Int J Qual Stud Health Well-being 2021; 16:1945206. [PMID: 34219610 PMCID: PMC8259813 DOI: 10.1080/17482631.2021.1945206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose Delay in reporting foot symptoms in patients with diabetes to health-care professionals is said to be responsible for limb amputation. While reasons for these delays have been investigated elsewhere, they are not well documented in Nigeria. This study explored the causes of delayed presentation in a Nigerian sample of patients with diabetic foot ulcers. Method The study followed an explorative qualitative design in which the lived experience of eight participants with diabetes were explored. The participants completed in-depth interviews which were digitally audio-recorded and transcribed verbatim. Data were analysed thematically using deductive reasoning. Results The study identified four themes which included knowledge and awareness of foot challenges, risk perception, health seeking triggers and behaviours and competing priority as the factors responsible for delay in presentation of diabetic foot complications. Conclusions Limited knowledge and awareness and negative health seeking behaviours including self-management and consultation of traditionalists were the major reasons for delays.
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Affiliation(s)
- Michael Opeoluwa Ogunlana
- Federal Medical Centre, Abeokuta, Nigeria.,College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Pragashnie Govender
- Discipline of Occupational Therapy, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Olufemi Oyeleye Oyewole
- Department of Physiotherapy , Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
| | | | | | - Olubiyi F Adesina
- Unit of Endocrinology, Department of Internal Medicine, Federal Medical Centre, Abeokuta, Nigeria
| | - Jabez Ariyo Akindipe
- Unit of Plastic Surgery, Department of Surgery, Federal Medical Centre, Abeokuta, Nigeria
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Abdul Wahab NA, Makmor Bakry M, Ahmad M, Mohamad Noor Z, Mhd Ali A. Exploring Culture, Religiosity and Spirituality Influence on Antihypertensive Medication Adherence Among Specialised Population: A Qualitative Ethnographic Approach. Patient Prefer Adherence 2021; 15:2249-2265. [PMID: 34675490 PMCID: PMC8502050 DOI: 10.2147/ppa.s319469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/21/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Hypertension is one of the major risk factors of stroke and leading risk factors for global death. Inadequate control of blood pressure due to medication non-adherence remains a challenge and identifying the underlying causes will provide useful information to formulate suitable interventions. PURPOSE This study aimed to explore the roles of culture, religiosity, and spirituality on adherence to anti-hypertensive medications. METHODOLOGY A semi-structured qualitative interview was used to explore promoters and barriers to medication adherence among hypertensive individuals residing in urban and rural areas of Perak State, West Malaysia. Study participants were individuals who are able to comprehend either in Malay or English, above 18 years old and on antihypertensive medications. Interview transcriptions from 23 participants were coded inductively and analyzed thematically. Codes generated were verified by three co-investigators who were not involved in transcribing process. The codes were matched with quotations and categorized using three levels of themes named as organizing, classifying and general themes. RESULTS Cultural aspects categorized as societal and communication norms were related to non-adherence. The societal norms related to ignorance, belief in testimony and anything "natural is safe" affected medication adherence negatively. Communication norms manifested as superficiality, indirectness and non-confrontational were also linked to medication non-adherence. Internal and organizational religiosity was linked to increased motivation to take medication. In contrast, religious misconception about healing and treatment contributed towards medication non-adherence. The role of spirituality remains unclear and seemed to be understood as related to religiosity. CONCLUSION Culture and religiosity (C/R) are highly regarded in many societies and shaped people's health belief and behaviour. Identifying the elements and mechanism through which C/R impacted adherence would be useful to provide essential information for linking adherence assessment to the interventions that specifically address causes of medication non-adherence.
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Affiliation(s)
- Noor Azizah Abdul Wahab
- Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, 50300, Malaysia
- Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur Royal College of Medicine Perak, Perak, 30450, Malaysia
| | - Mohd Makmor Bakry
- Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, 50300, Malaysia
| | - Mahadir Ahmad
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, 50300, Malaysia
| | - Zaswiza Mohamad Noor
- Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur Royal College of Medicine Perak, Perak, 30450, Malaysia
| | - Adliah Mhd Ali
- Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, 50300, Malaysia
- Correspondence: Adliah Mhd Ali Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, MalaysiaTel +603-9289 7964Fax +603-2698 3271 Email
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Ligita T, Harvey N, Wicking K, Francis K, Nurjannah I. Diabetes self-management: what role does the family play? HEALTH EDUCATION 2020. [DOI: 10.1108/he-12-2019-0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis paper aims to explicate one of the major findings of a research study seeking to understand how Indonesian people with diabetes learn about their disease. The one key finding discussed in this paper is how families influence the learning and self-management processes adopted by Indonesian people with diabetes.Design/methodology/approachA grounded theory methodology was adopted to investigate how Indonesian people with diabetes learn about their disease. Twenty-eight semi-structured interviews were undertaken with Indonesian people living with diabetes, families of people living with diabetes, healthcare professionals and other healthcare providers. Data was analysed by using constant comparative analysis during three coding stages.FindingsThe study explicated the basic social process of how people with diabetes in Indonesia learn about their disease through a generated theory “Learning, choosing, and acting: self-management of diabetes in Indonesia”. This study found family engagement was integral to Indonesian people living with diabetes who were self-managing their disease. Families assisted with seeking information, providing recommendations, selecting and implementing actions, appraising implemented actions, and informing others about their experiences. By acknowledging that family is involved in this process, the healthcare professional can adequately provide health education to both the person with diabetes and their families. Involving families in health education is crucial as family can influence decision making made by people with diabetes in a proper or improper way. Thus, clinicians need to also skilfully recognise difficulties these people encounter by monitoring their self-management progress and by working closely with them and their family members.Originality/valueThis is the first study conducted in Indonesia that specifically investigates the process of how people with diabetes learn about their disease. The involvement of families in this process is a central finding of the study. Families can enhance the overall health and well-being of the person with diabetes, aid in early recognition of aberration to health status and trigger the initiation of interventions to re-establish homeostasis if they are actively engaged and supported by health professionals.
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Factors of Health Promotion Behaviour (HPB) and Elderly Health Diseases in Malaysia. JOURNAL OF POPULATION AGEING 2020. [DOI: 10.1007/s12062-020-09284-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Treatment-Seeking Behavior Among Male Civil Servants in Northeastern Malaysia: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082713. [PMID: 32326447 PMCID: PMC7216173 DOI: 10.3390/ijerph17082713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/09/2020] [Accepted: 04/13/2020] [Indexed: 02/05/2023]
Abstract
Background: Men's health in Malaysia is slowly gaining more attention, but minimal research has examined how Malaysian men behave and seek treatment. While few studies have investigated men's treatment-seeking behavior (TSB), those that have been conducted seem to be inconclusive and tend to yield contradictory findings. Objectives: This paper aims to determine the proportion of inappropriate TSB and to explore in-depth treatment-seeking behavior among male civil servants in northeastern Malaysia. Methods: This paper adopted a mixed-methods approach, specifically a concurrent parallel study design. A quantitative study using a self-administered questionnaire was performed to identify the proportion of appropriate and inappropriate TSB among male civil servants in northeastern Malaysia. Concurrently, a qualitative study was conducted involving six focus group discussion sessions, and the results of both parts were integrated to provide a detailed explanation of TSB among the participants. Results: A total of 381 participants were involved in the quantitative study, yielding a response rate of 94.8%; 246 (64.6%) engaged in inappropriate TSB. Some of the reported morbidities among the participants were hypertension (26.5%) and diabetes mellitus (26.2%). From the qualitative study, a main theme related to TSB emerged with several sub-themes, which were health literacy, stage of seeking treatment, preference for alternative treatment, perceived threat of illness, self-treatment, and the influence of family members and others. Conclusions: TSB among male civil servants in northeastern Malaysia is poor, and the factors contributing to it are multidimensional. This study has provided new valuable evidence on men's TSB in northeastern Malaysia. The findings can be used to facilitate and improve current policies and the implementation of men's health services throughout the country.
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Morowatisharifabad MA, Rahimi T, Farajkhoda T, Zadeh HF. Understanding Interpersonal Influences on the Use of Formal Health Services among a Population of Iranian Women in Reproductive Age: A Qualitative Study. Open Access Maced J Med Sci 2019; 7:1531-1535. [PMID: 31198468 PMCID: PMC6542402 DOI: 10.3889/oamjms.2019.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND One of the most important factors contributing to using formal health care services by women is people who are involved in the social network around them. AIM This study aimed to understand the interpersonal influences on the use of formal health services among Iranian women of reproductive age. METHODS This study is a deductive content analysis approach based on the Health Promotion Model. Twenty-two semi-structured interviews were done with women of reproductive age and health care staffs in Qom, Iran. Transcripts were analysed by a deductive content analysis approach based on the Health Promotion Model (HPM). RESULTS Three main categories and eight subcategories were drawn consisting of (1) social support with 4 subcategories including "Family support and influence", "support of religious people", "support of health care providers" and "negative social support"; (2) social pressure and expectations with 2 subcategories including "feeling pressure due to role-playing" and "society's expectations regarding women's health", and (3) healthy role models with 2 subcategories including "family role models" and "modeling friends and peers in taking action for treatment". CONCLUSION A positive interpersonal influence in women acts as a strong incentive to seek health care when they are suffering from a disease, and prevents the chronicity of the disease by timely treatment.
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Affiliation(s)
| | - Tahereh Rahimi
- Department of Health Education and Promotion, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Tahmineh Farajkhoda
- Research Center for Nursing and Midwifery Care, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Fallah Zadeh
- Department of Biostatistics and Epidemiology, Research Center of Prevention and Epidemiology of Non-Communicable Disease, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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14
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Zhou J, Liu F, Zhou H. Understanding health food messages on Twitter for health literacy promotion. Perspect Public Health 2018. [PMID: 29513075 DOI: 10.1177/1757913918760359] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS With the popularity of social media, Twitter has become an important tool to promote health literacy. However, many health-related messages on Twitter are dead-ended and cannot reach many people. This is unhelpful for health literacy promotion. This article aims to examine the features of online health food messages that people like to retweet. METHODS We adopted rumour theory as our theoretical foundation and extracted seven characteristics (i.e. emotional valence, attractiveness, sender's authoritativeness, external evidence, argument length, hashtags, and direct messages). A total of 10,025 health-related messages on Twitter were collected, and 1496 messages were randomly selected for further analysis. Each message was treated as one unit and then coded. All the hypotheses were tested with logistic regression. RESULTS Emotional valence, attractiveness, sender's authoritativeness, argument length, and direct messages in a Twitter message had positive effects on people's retweet behaviour. The effect of external evidence was negative. Hashtags had no significant effect after consideration of other variables. CONCLUSION Online health food messages containing positive emotions, including pictures, containing direct messages, having an authoritative sender, having longer arguments, or not containing external URLs are more likely to be retweeted. However, a message only containing positive or negative emotions or including direct messages without any support information will not be retweeted.
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Affiliation(s)
- J Zhou
- School of e-Commerce and Logistics Management, Henan University of Economics and Law, No. 180 Jinshui East Road, Zhengzhou 450046, China
| | - F Liu
- University of Queensland, St Lucia, QLD, Australia
| | - H Zhou
- Henan Provincial Institute of Scientific and Technical Information, Zhengzhou, China
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15
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Wallace DD, Gonzalez Rodriguez H, Walker E, Dethlefs H, Dowd RA, Filipi L, Barrington C. Types and sources of social support among adults living with type 2 diabetes in rural communities in the Dominican Republic. Glob Public Health 2018; 14:135-146. [PMID: 29484919 DOI: 10.1080/17441692.2018.1444782] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Type 2 diabetes management hinges on various determinants, including the role of interpersonal relationships in self-management behaviours. The aim of this study was to explore the types and sources of social support received by adults in the diabetes diagnosis and self-management processes. We conducted qualitative interviews with 28 men and women at two rural clinics in the Dominican Republic and used a combination of narrative and thematic analytic techniques to identify key sources and types of social support in their diabetes experiences. Participants described three stages in their diabetes experience: diagnosis, programme-enrolment, and long-term management. During diabetes diagnosis, most participants described receiving no support. At the programme-enrolment stage, friends and neighbours frequently provided informational or instrumental support to get to the clinic. In long-term management, cohabiting partners provided the most support, which was often assistance with their diet. Our findings highlight he need to assess and leverage distinct types and sources of social support at different stages of the diabetes experience.
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Affiliation(s)
- Deshira D Wallace
- a Department of Health Behavior, Gillings School of Global Public Health , University of North Carolina , Chapel Hill , NC , USA
| | - Humberto Gonzalez Rodriguez
- a Department of Health Behavior, Gillings School of Global Public Health , University of North Carolina , Chapel Hill , NC , USA
| | - Elizabeth Walker
- b Department of Medicine, Albert Einstein College of Medicine , Yeshiva University , Bronx , NY , USA
| | | | | | - Linda Filipi
- d Saddleback Diabetes Clinic , Laguna Hills , CA , USA
| | - Clare Barrington
- a Department of Health Behavior, Gillings School of Global Public Health , University of North Carolina , Chapel Hill , NC , USA
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16
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Ho HY, Chen MH, Lou MF. Exploring the experiences of older Chinese adults with comorbidities including diabetes: surmounting these challenges in order to live a normal life. Patient Prefer Adherence 2018; 12:193-205. [PMID: 29430173 PMCID: PMC5796462 DOI: 10.2147/ppa.s147756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Many people with diabetes have comorbidities, even multimorbidities, which have a far-reaching impact on the older adults, their family, and society. However, little is known of the experience of older adults living with comorbidities that include diabetes. AIM The aim of this study was to explore the experience of older adults living with comorbidities including diabetes. METHODS A qualitative approach was employed. Data were collected from a selected field of 12 patients with diabetes mellitus in a medical center in northern Taiwan. The data were analyzed by Colaizzi's phenomenological methodology, and four criteria of Lincoln and Guba were used to evaluate the rigor of the study. RESULTS The following 5 themes and 14 subthemes were derived: 1) expecting to heal or reduce the symptoms of the disease (trying to alleviate the distress of symptoms and trusting in health practitioners combining the use of Chinese and Western medicines); 2) comparing complex medical treatments (differences in physician practices and presentation, conditionally adhering to medical treatment, and partnering with medical professionals); 3) inconsistent information (inconsistent health information and inconsistent medical advice); 4) impacting on daily life (activities are limited and hobbies cannot be maintained and psychological distress); and 5) weighing the pros and cons (taking the initiative to deal with issues, limiting activity, adjusting mental outlook and pace of life, developing strategies for individual health regimens, and seeking support). Surmounting these challenges in order to live a normal life was explored. CONCLUSION This study found that the experience of older adults living with comorbidities including diabetes was similar to that of a single disease, but the extent was greater than a single disease. The biggest difference is that the elderly think that their most serious problem is not diabetes, but rather, the comorbidities causing life limitations. Therefore, compared to the elderly suffering from a single disease of diabetes, medical professionals not only care about physiological data of the elderly but also pay attention to the impact of comorbidity on their lives.
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Affiliation(s)
- Hsiu-Yu Ho
- School of Nursing, College of Medicine, National Taiwan University
- Department of Nursing, Yuanpei University of Medical Technology
| | - Mei-Hui Chen
- Department of Nursing, Yuanpei University of Medical Technology
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, Republic of China
| | - Meei-Fang Lou
- School of Nursing, College of Medicine, National Taiwan University
- Correspondence: Meei-Fang Lou, School of Nursing, College of Medicine, National Taiwan University, No 1, Sec 1, Jen-Ai Rd, Taipei 10051, Taiwan, Republic of China, Tel +886 2 23123 456 ext 88441, Email
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17
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Kuske S, Schiereck T, Grobosch S, Paduch A, Droste S, Halbach S, Icks A. Diabetes-related information-seeking behaviour: a systematic review. Syst Rev 2017; 6:212. [PMID: 29065919 PMCID: PMC5655894 DOI: 10.1186/s13643-017-0602-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 10/02/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Information-seeking behaviour is necessary to improve knowledge on diabetes therapy and complications. Combined with other self-management skills and autonomous handling of the disease, it is essential for achieving treatment targets. However, a systematic review addressing this topic is lacking. The aims of this systematic review were to identify and analyse existing knowledge of information-seeking behaviour: (1) types information-seeking behaviour, (2) information sources, (3) the content of searched information, and (4) associated variables that may affect information-seeking behaviour. METHODS The systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) requirements. MEDLINE, CINAHL, EMBASE, ScienceDirect, PsycInfo, Cochrane Library, Web of Science, CCMed, ERIC, Journals@OVID, Deutsches Ärzteblatt and Karlsruher virtueller Katalog (KvK) databases were searched. Publications dealing with information-seeking behaviour of people with diabetes mellitus published up to June 2015 were included. A forward citation tracking was performed in September 2016 and June 2017. Additionally, an update of the two main databases (MEDLINE, CINAHL) was conducted, considering studies published up to July 2017. Studies published in languages other than English or German were excluded, as well as letters, short reports, editorials, comments and discussion papers. A study selection and the critical appraisal of the selected studies were performed independently by two reviewers. A third reviewer was consulted if any disagreement was found. Data extraction and content analysis were performed using selected dimensions of Wilson's 'model of information behaviour'. RESULTS Twenty-six studies were included. Five 'types of information-seeking behaviour' were identified, e.g. passive and active search. The 'Internet' and 'healthcare professionals' were the most frequently reported sources. 'Diet', 'complications', 'exercise' and 'medications and pharmacological interactions' were the most frequently identified content of information. Seven main categories including associated variables were identified, e.g. 'socioeconomic', 'duration of DM', and 'lifestyle'. CONCLUSION The systematic review provides a valuable overview of available knowledge on the information-seeking behaviour of people with diabetes mellitus, although there are only a few studies. There was a high heterogeneity regarding the research question, design, methods and participants. Although the Internet is often used to seek information, health professionals still play an important role in supporting their patients' information-seeking behaviour. Specific needs of people with diabetes must be taken into consideration. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016037312.
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Affiliation(s)
- Silke Kuske
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Tim Schiereck
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Sandra Grobosch
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Andrea Paduch
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Sigrid Droste
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Sarah Halbach
- Department for Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research (CHSR), University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center, Düsseldorf, Germany
- German Center for Diabetes Research, Neuherberg, Germany
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18
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Molnar A. Children as agents of change in combatting antibiotic resistance. J Health Serv Res Policy 2017; 22:258-260. [DOI: 10.1177/1355819617701512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Antibiotic resistance is a worldwide problem and changes are needed in the way antibiotics are used. The value of engaging children as key contributors in health care campaigns to increase the appropriate use of antibiotics has not been fully recognized. Little is known about how to design educational materials for children in order to enable them to be agents of change in their communities. Science education needs to improve the way it engages children so as to give them the tools needed to make responsible decisions on antibiotic use.
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Affiliation(s)
- Andreea Molnar
- Lecturer in Web and Mobile Development, School of Creative Technologies, University of Portsmouth, UK
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19
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Moradi Y, Nasehi M, Asadi-Lari M, Khamseh ME, Baradaran HR. The relationship between social capital components and control of type 2 diabetes: A path analysis model. Med J Islam Repub Iran 2017; 31:21. [PMID: 29445650 PMCID: PMC5804475 DOI: 10.18869/mjiri.31.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Indexed: 11/15/2022] Open
Abstract
Background: Social capital is an important interpersonal organizational resource that may affect health behaviors and seems to be
an important factor in chronic diseases. Considering the lack of evidence on this topic, in the present study, we aimed at investigating
the association between components of social capital, socioeconomic condition, and controlling Type 2 diabetes mellitus in Iran.
Methods: This study was conducted on 300 patients with Type 2 diabetes in Tehran, Iran. In this study, simple random sampling
method was used for data collection. Path analysis model was used to examine the potential association between social capital components
and to determine the factors that control Type 2 diabetes.
Results: In the present study, most of the participants were female (70.7%) and married (78.7%). Path coefficients were calculated
by a series of multiple regression analyses based on the conceptual model. The final model had a proper fit with Chi-square = 2.08 (DF
= 1, P = 0.049), GFI = 0.542, AGFI = 0.915, NFI = 0.228, RFI = 0.284, IFI = 0.299, TLI = 0.292, CFI = 0.219, and RMSEA = 0.033.
The Groups and networks (network) (β = 0.051, p = 0.036) and trust and solidarity (β = -0.018, p = 0.028) had a direct positive and
negative effect on HbA1C, respectively. The results also revealed that education levels had a direct positive effect on groups and networks
(network) (β = 0.118, p = 0.036), trust and solidarity (β = 0.082, p = 0.007), information and communication (β = 0.037, p =
0.027), and contribution in team works and public activities (β = 0.064, p = 0.003). In addition, education levels had an indirect positive
effect on HbA1C through their effect on groups and networks (network), trust and solidarity, and information and communication.
Conclusion: Social capital has a significant relationship with diabetes. Although it was not specified clearly which components of
social capital were associated with diabetes, trust and solidarity showed a negative direct effect on HbA1C, respectively. Therefore,
developing and implementing local and collective programs to build trust and increase the standards of social trust in patients with
diabetes can be effective in controlling HbA1C.
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Affiliation(s)
- Yousef Moradi
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahshid Nasehi
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohamad Ebrahim Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Baradaran
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
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Oldenburg B, Wickramasinghe K, Byrnes A. Building Noncommunicable Disease Research Capacity in the South Asian Region: The ASCEND Program. Asia Pac J Public Health 2016; 28:6S-9S. [PMID: 26792912 DOI: 10.1177/1010539515625248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - Allison Byrnes
- The University of Melbourne, Melbourne, Victoria, Australia Monash University, Melbourne, Victoria, Australia
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21
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Affiliation(s)
- Wah Yun Low
- Research Management Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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